PROJECT SUMMARY The science of health care simulation has advanced rapidly over the last two decades. Several key studies link simulation-based training with improved patient and system-level outcomes. Despite significant progress in healthcare simulation research, critical gaps in knowledge remain, thus limiting our ability to fully leverage simulation as a mechanism to improve healthcare quality and patient safety. Simulation-based researchers continue to struggle with designing realistic, fully integrated simulation experiences, defining meaningful outcome measures, and conceptualizing the dynamic, complex nature of healthcare systems. Emergency medicine as a specialty is well-positioned advance simulation-based research and patient safety. Emergency medicine has a broad scope of practice, resulting in medical knowledge and procedural skill requirements that cross multiple disciplines. From a systems perspective, the emergency department is a microcosm of the healthcare system and provides opportunity to evaluate processes that apply to multiple healthcare delivery environments. This grant seeks funding for a one-day conference, the Academic Emergency Medicine (AEM) Consensus Conference, ?Catalyzing System Change Through Healthcare Simulation: Systems, Competency, and Outcomes? that will address critical barriers in simulation-based research. The specific aims of this conference are to (1) develop a research agenda that specifically addresses existing barriers to effective implementation of simulation-based interventions that directly impact patient safety and healthcare quality, (2) provide consensus recommendations that will optimize future simulation? based research and education efforts and prioritize research agenda items to foster rapid advancement of knowledge, methodology, implementation of simulation-based interventions, and (3) establish the foundation needed to support a collaborative emergency medicine simulation-based research network. Academic Emergency Medicine has hosted a consensus conference for the past 16 years. Each conference results in the development of a research agenda that addresses a timely issue pertinent to the delivery of emergency care. This conference will bring together experts from emergency medicine, implementation science, human factors, safety science, systems engineering, computer science, and education, thus ensuring a rigorous discourse focusing on critical knowledge and methodological gaps in simulation research. The journal Academic Emergency Medicine will disseminate conference proceedings and relevant original research. Overall, this conference will advance simulation-based research and shed new light on healthcare systems research methodologies and the study of process-level outcomes with the goal of improving patient safety.